Wednesday, January 28, 2015

House Speaker: 'No plans' to expand Medicaid coverage

Florida House Speaker Steve Crisafulli on Wednesday said his chamber has "no plans" to expand Medicaid coverage to an additional 800,000 residents during the upcoming legislative session.

"We do not plan to do anything on Medicaid expansion," Crisafulli told reporters and editors at the annual Associated Press Legislative Planning Day at the Capitol. "I am a never-say-never kind of guy, and certainly anything can come about that provides opportunity, but at this time we do not plan to hear Medicaid expansion."

Crisafulli and Senate President Andy Gardiner appeared together at the event, and expansion of health coverage was the only issue in which they even slightly disagreed.

Last month, Gardiner described as "intriguing" a proposal that would accept billions of dollars available under the federal Affordable Care Act to provide health care through private insurers to low- and moderate-income residents —- an idea similar to expanding Medicaid. On Wednesday, Gardiner stayed flexible on the issue.

"There probably should be some sort of an overall discussion," Gardiner said. "In the Senate, we continue to remain open to the dialogue, but we understand the realities in which we live."

The reality is that while Crisafulli didn't absolutely rule out the possibility of an alternative health-care plan, he called Medicaid "a broken system." He also pointed with pride to the Legislature's 2011 Medicaid overhaul, which moved most beneficiaries into HMOs and other types of managed-care plans.

Gardiner said he'd been watching developments in Indiana, where Republican Gov. Mike Pence announced Tuesday that his state had accepted federal funding under the Affordable Care Act for an alternative to expanding Medicaid. The Indiana plan is expected to extend health-care coverage to 350,000 people.

Gardiner, R-Orlando, and Crisafulli, R-Merritt Island, were sworn into the Legislature's top positions in November and are preparing for the March 3 start of the legislative session. They agreed on most of a legislative agenda, such as tax cuts, water policy, controls on high-stakes testing, more funding for education and the environment, adoption incentives and a plan to expand economic independence for people with disabilities.

On water policy, the Senate president and House speaker agreed that Florida must make a permanent commitment to maintaining access to clean water in every part of the state. They also pledged transparency in legislative spending under Amendment I, a conservation ballot initiative that passed in November with 75 percent of the vote.

The Senate president, whose son Andrew was born with Down syndrome, presented a six-point plan to promote educational and vocational opportunities for Floridians with —- as Gardiner likes to call them —- "unique abilities." The plan would establish a statewide postsecondary designation for such students, expand scholarships, teach financial literacy and honor businesses that hire workers with disabilities.

On high-stakes testing, Crisafulli said he didn't believe the state could "back down" from such accountability, because it had produced "remarkable results." But to parents and teachers who argue that testing has taken over the education process, he said, "We hear you."

He said lawmakers were discussing making more information about testing requirements available to the public.

"There's duplication in testing from district to district, with regard to what the districts are doing with the overlay of the state," he said. "And we're going to look at that. … Some of these tests that are taking place are certainly state tests, but there are also county tests or district tests that are being put on top of that."

But Senate Minority Leader Arthenia Joyner, D-Tampa, said parents are "rebelling against high-stakes testing. It's reached critical mass, and I believe the politicians are listening to the people."

On medical marijuana, too, Joyner said the majority of Floridians support it, as evidenced by the nearly 58 percent who voted to legalize therapeutic pot in November.

"The people have spoken, and it appears my colleagues on the other side of the aisle are listening," she said —- a reference to a bill filed Monday by Sen. Jeff Brandes, R-St. Petersburg, that would allow patients to use marijuana if they suffer from diseases such as cancer, AIDS, epilepsy or multiple sclerosis.

As to the Democrats' legislative agenda, both Joyner and House Minority Leader Mark Pafford, D-West Palm Beach, tried to draw hope where they could in the Republican-dominated Legislature.

"We want a full debate" on Medicaid expansion, Pafford said. "You heard the speaker —- he's not a never-say-never guy."

Joyner, who said expanding Medicaid remains one of her top priorities, said she was hopeful because some members of powerful business lobbies are backing an alternative health-care coverage plan.

"Maybe this is the year Florida will embrace this concept that is so fundamental to the health care and economics of our state," she said.